Some of the differences between in-hospital and ambulatory medicine and their implications for the teaching and practice of ambulatory care are explored. The availability of time, the role of patient cooperation, and the decision-making process differ in the two settings. (MLW)

A total of 200 patients were interviewed at 2 out-patient settings to quantify the patients' perspectives on their illness by measuring their requests for help. Results showed specific requests were made by most patients that focused either on the problem and/or the treatment. (GLR)

The implementation of a model internal medicine group practice at the University of Colorado Medical Center is described, and the first 19 months of its operation are reported. It was formed to improve house staff experience in ambulatory internal medicine, allowing six residents to participate with two faculty internists in full-time continuous…

An ambulatory medicine program for university hospital clinic residents was found to be effective in improving students' knowledge, enhancing attitudes toward the clinic, and improving performance of influenza vaccinations. No adverse program effects were found. (MSE)

An academic general medicine clinic (GMC) was studied and profiles were generated to determine current patterns, shortcomings, and potential solutions. Conclusions include that GMC offers insufficient variety of patient presentations for optimal postgraduate medical education and inadequate accessibility for comprehensive medical care. (Author/JMD)

A review of 287 patient visits to a teaching hospital polyclinic shows that most patients had multiple problems that required the help of subspecialists. However, the patients' needs for accessibility, comprehensiveness, coordination, and continuity are as great as those of patients receiving primary care. Implications for academic internal…

A cost containment program initiated in 1975 on the medical teaching service of Charlotte Memorial Hospital, a University of North Carolina affiliated hospital, has led to a significant improvement in hospital house staff utilization of facilities and procedures. In the outpatient setting an actual reduction in patient-encounter cost was realized…

The implementation of a continuity of a care clinic in a highly subspecialized Veterans Administration internal medicine training program for postgraduate medical students is described, with focus on resolving problems created by the idiosyncratic administrative features and resource limitations of the hospital. (Author/JMD)

Internal medicine residency programs that put increasing emphasis on outpatient experience and continuity of care place demands on residents that conflict with inpatient responsibilities. The development and implementation at the University of Virginia Hospital of a rotational scheduling system aimed at alleviating the conflict is described.…

The purpose of this study was to assess the effect of organizational changes in the general medicine clinic on residents' and patients' satisfaction, including their perceptions of the quality of care. Questionnaires to assess satisfaction were administered to the residents (N=80) and patients (N=577) using a pre- and posttesting design. (MLW)

A study of precepting conversations between 11 pairs of internal medicine interns and faculty preceptors found strategies used to correct the interns consistent with pedagogic norms favoring discovery learning and with societal norms favoring egalitarianism and respect for individuals. However, this raises questions about effects on interns'…